Provider Demographics
NPI:1245707637
Name:CARREON-ROMERO, VIRIDIANA (LCSW, LAADC-CA)
Entity type:Individual
Prefix:
First Name:VIRIDIANA
Middle Name:
Last Name:CARREON-ROMERO
Suffix:
Gender:F
Credentials:LCSW, LAADC-CA
Other - Prefix:
Other - First Name:VIRIDIANA
Other - Middle Name:
Other - Last Name:CARREON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAADC-CA
Mailing Address - Street 1:PO BOX 1576
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-1576
Mailing Address - Country:US
Mailing Address - Phone:760-809-2733
Mailing Address - Fax:
Practice Address - Street 1:1002 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4605
Practice Address - Country:US
Practice Address - Phone:760-741-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCI2231214101YA0400X
CA1247641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)